New patient registration form

Please fill in the registration form below to register as a patient. You can also download the NHS form to fill out and hand in at reception.

We ask every new patient to fill out this form and hand back to a Patient Assistant once completed. All information is confidential and belongs to you, and will help us to support you to stay fit and well.

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You might find that other parts of your life are affecting your physical health. We are here to provide support and guidance in these areas. Please tick every box that sounds interesting, and we’ll put you in touch with one of our team.

Money

Bromley by Bow Centre can support you to manage your money on a low budget, get advice on employment law, access benefits and welfare support, reduce your utility costs and deal with debt.

You can also visit the Financially Inclusive Tower Hamlets website which has lots of information www.fith.org.uk

Housing

The advice team at Bromley by Bow Centre can help you with housing advice. You can also get in touch with your housing provider.

Work

Bromley by Bow Centre employment team can support you to find volunteering or work opportunities in the local area.

Alcohol

Bromley by Bow Centre can support you to manage your money on a low budget, get advice on employment law, access benefits and welfare support, reduce your utility costs and deal with debt.

You can also visit the Financially Inclusive Tower Hamlets website which has lots of information www.fith.org.uk

Computer Skills

If you need support to learn how to use a computer, get online and access social media and other services you can attend digital inclusion classes at Bromley by Bow Centre.

By ticking these boxes you give consent that relevant information from this form will be shared with the service.